Group Healthcare Models

Group Antenatal Care: Effectiveness for Maternal/Infant and HIV Prevention Outcomes and Contextual Factors Linked to Implementation Success in Malawi

This study tests the effectiveness of an evidence-based model of group antenatal care compared to individual (usual) antenatal care. We simultaneously identify the degree of successful implementation success and factors associated with success across 6 antenatal clinics in Blantyre District, Malawi. If results are negative, governments will avoid spending on ineffective care. Positive maternal, neonatal, and HIV-related outcomes of group antenatal care will save lives, impact the cost and quality of antenatal care, and influence health policy as governments adopt this transformative model of care nationally. Registered with clinical trials.gov on September 28, 2017.

Black Midwives for Black Women: Maternity Care to Improve Trust and Attenuate Structural Racism

This study, funded by PCORI, compares the usual maternity care received by most women to a new model of maternity care that combines four effective strategies to improve Black women’s experiences and outcomes during pregnancy and postpartum. In Melanated Group Midwifery Care (MGMC), Black women will receive prenatal care from a Black midwife in groups with the same 8-10 other Black women throughout pregnancy. In pregnancy and into the first year postpartum, MGMC patients will stay connected to the health system through a proactive care coordinator, who is a Black licensed nurse. After having their babies, patients in MGMC will also be supported by a trained postpartum doula.

Centering those Engaged in Transactional Sex: A PrEP Innovation for Getting to Zero

Preventing new HIV infections (i.e., “Getting to Zero”) by 2030 is a public health priority, and sex workers (SW) are a key target population, highlighting the need for innovative HIV prevention methods. For high-risk HIV-negative SW, Pre-exposure Prophylaxis (PrEP), a daily pill to prevent acquiring HIV, is empowering, user-controlled and requires no partner negotiation. Using a participatory implementation science framework to prevent new HIV infections and to improve the health among sex workers, their clients, and their communities, our interdisciplinary research team aims to determine whether a community empowered group-care model, adapted in partnership with SW and community stakeholders (PrEP+), is a feasible and acceptable way to facilitate PrEP education, navigation and persistence for HIV- sex workers in Chicago, IL.

Mzake ndi Mzake: A Community-based Implementation Model for HIV Prevention and Testing in Malawi

This study tests a 3-step (prepare, roll out, and sustain) community implementation model (CBPR-IM) to roll out and sustain an HIV prevention program shown to reduce risky behaviors for both adults and adolescents in low-resource communities of southern Malawi. Testing this theory-based model advances implementation science and strengthens community capacity to implement evidence-based programs.